Efficacy of heart transplantation in patients with a failing Fontan: a systematic review and meta-analysis
Background As the population of patients with Fontan palliation grows, so does the number of patients with Fontan failure, necessitating heart transplantation. However, due to mainly small-sized studies, outcomes after heart transplantation in these patients remain unclear. The objective of this stu...
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Gespeichert in:
| Autor*in: |
Hassan, Wardah [verfasserIn] Kotak, Sohny [verfasserIn] Khatri, Mahima [verfasserIn] Ahmed, Areeba [verfasserIn] Ahmed, Jawad [verfasserIn] Ali, Syed Saad [verfasserIn] Khan, Taj M. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2021 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: The cardiothoracic surgeon - [Berlin, Heidelberg] : Springer, 2019, 29(2021), 1 vom: 25. Feb. |
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| Übergeordnetes Werk: |
volume:29 ; year:2021 ; number:1 ; day:25 ; month:02 |
| Links: |
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| DOI / URN: |
10.1186/s43057-021-00043-6 |
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| Katalog-ID: |
SPR043332218 |
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| 245 | 1 | 0 | |a Efficacy of heart transplantation in patients with a failing Fontan: a systematic review and meta-analysis |
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| 520 | |a Background As the population of patients with Fontan palliation grows, so does the number of patients with Fontan failure, necessitating heart transplantation. However, due to mainly small-sized studies, outcomes after heart transplantation in these patients remain unclear. The objective of this study was to review the available literature and conduct a meta-analysis to provide well-powered and generalizable estimates of outcomes after heart transplantation in patients with a failing Fontan. Main text PubMed, Embase, and MEDLINE databases were searched for original studies of patients with a failing Fontan who underwent heart transplantation. The outcomes included were 1-year and 5-year survival, acute rejection, renal dysfunction, sepsis, and multi-organ failure. Proportions were pooled using random effects models to derive pooled proportions (PPs) and corresponding 95% confidence intervals (CIs). Meta-regression analysis was done to study the effects of age and gender on key outcomes. Sixteen retrospective single-center cohort studies with 426 Fontan patients undergoing heart transplantation were included in this meta-analysis. Pooled analysis of this study further revealed that 1-year survival after heart transplantation was 79.9% ([75.8%, 83.7%]; I2 = 1.92%), and 5-year survival rate was 72.5% ([62.1%, 81.9%]; I2 = 72.12%). Secondary outcomes after heart transplantation of failed Fontan procedure were acute rejection (PP 20% [7.4%, 36.8%]; I2 = 72.48%), renal dysfunction (PP 31.3% [10.5%, 57.2%]; I2 = 75.42%), multi-organ failure (PP 18.6% [2.8 to 43.9%]; I2= 69.60%), and sepsis (PP 21.1% [9%, 36.8%]; I2 = 61.19%). Conclusion Cardiac transplantation in patients with a failing Fontan is associated with acceptable interventional success and improved survival rates. | ||
| 650 | 4 | |a Fontan |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Adult congenital heart disease |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Congenital heart surgery |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Kotak, Sohny |e verfasserin |4 aut | |
| 700 | 1 | |a Khatri, Mahima |e verfasserin |4 aut | |
| 700 | 1 | |a Ahmed, Areeba |e verfasserin |4 aut | |
| 700 | 1 | |a Ahmed, Jawad |e verfasserin |4 aut | |
| 700 | 1 | |a Ali, Syed Saad |e verfasserin |4 aut | |
| 700 | 1 | |a Khan, Taj M. |e verfasserin |4 aut | |
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10.1186/s43057-021-00043-6 doi (DE-627)SPR043332218 (DE-599)SPRs43057-021-00043-6-e (SPR)s43057-021-00043-6-e DE-627 ger DE-627 rakwb eng Hassan, Wardah verfasserin aut Efficacy of heart transplantation in patients with a failing Fontan: a systematic review and meta-analysis 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background As the population of patients with Fontan palliation grows, so does the number of patients with Fontan failure, necessitating heart transplantation. However, due to mainly small-sized studies, outcomes after heart transplantation in these patients remain unclear. The objective of this study was to review the available literature and conduct a meta-analysis to provide well-powered and generalizable estimates of outcomes after heart transplantation in patients with a failing Fontan. Main text PubMed, Embase, and MEDLINE databases were searched for original studies of patients with a failing Fontan who underwent heart transplantation. The outcomes included were 1-year and 5-year survival, acute rejection, renal dysfunction, sepsis, and multi-organ failure. Proportions were pooled using random effects models to derive pooled proportions (PPs) and corresponding 95% confidence intervals (CIs). Meta-regression analysis was done to study the effects of age and gender on key outcomes. Sixteen retrospective single-center cohort studies with 426 Fontan patients undergoing heart transplantation were included in this meta-analysis. Pooled analysis of this study further revealed that 1-year survival after heart transplantation was 79.9% ([75.8%, 83.7%]; I2 = 1.92%), and 5-year survival rate was 72.5% ([62.1%, 81.9%]; I2 = 72.12%). Secondary outcomes after heart transplantation of failed Fontan procedure were acute rejection (PP 20% [7.4%, 36.8%]; I2 = 72.48%), renal dysfunction (PP 31.3% [10.5%, 57.2%]; I2 = 75.42%), multi-organ failure (PP 18.6% [2.8 to 43.9%]; I2= 69.60%), and sepsis (PP 21.1% [9%, 36.8%]; I2 = 61.19%). Conclusion Cardiac transplantation in patients with a failing Fontan is associated with acceptable interventional success and improved survival rates. Fontan (dpeaa)DE-He213 Adult congenital heart disease (dpeaa)DE-He213 Congenital heart surgery (dpeaa)DE-He213 Kotak, Sohny verfasserin aut Khatri, Mahima verfasserin aut Ahmed, Areeba verfasserin aut Ahmed, Jawad verfasserin aut Ali, Syed Saad verfasserin aut Khan, Taj M. verfasserin aut Enthalten in The cardiothoracic surgeon [Berlin, Heidelberg] : Springer, 2019 29(2021), 1 vom: 25. Feb. (DE-627)1688112510 (DE-600)3006146-5 2662-2203 nnns volume:29 year:2021 number:1 day:25 month:02 https://dx.doi.org/10.1186/s43057-021-00043-6 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 29 2021 1 25 02 |
| spelling |
10.1186/s43057-021-00043-6 doi (DE-627)SPR043332218 (DE-599)SPRs43057-021-00043-6-e (SPR)s43057-021-00043-6-e DE-627 ger DE-627 rakwb eng Hassan, Wardah verfasserin aut Efficacy of heart transplantation in patients with a failing Fontan: a systematic review and meta-analysis 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background As the population of patients with Fontan palliation grows, so does the number of patients with Fontan failure, necessitating heart transplantation. However, due to mainly small-sized studies, outcomes after heart transplantation in these patients remain unclear. The objective of this study was to review the available literature and conduct a meta-analysis to provide well-powered and generalizable estimates of outcomes after heart transplantation in patients with a failing Fontan. Main text PubMed, Embase, and MEDLINE databases were searched for original studies of patients with a failing Fontan who underwent heart transplantation. The outcomes included were 1-year and 5-year survival, acute rejection, renal dysfunction, sepsis, and multi-organ failure. Proportions were pooled using random effects models to derive pooled proportions (PPs) and corresponding 95% confidence intervals (CIs). Meta-regression analysis was done to study the effects of age and gender on key outcomes. Sixteen retrospective single-center cohort studies with 426 Fontan patients undergoing heart transplantation were included in this meta-analysis. Pooled analysis of this study further revealed that 1-year survival after heart transplantation was 79.9% ([75.8%, 83.7%]; I2 = 1.92%), and 5-year survival rate was 72.5% ([62.1%, 81.9%]; I2 = 72.12%). Secondary outcomes after heart transplantation of failed Fontan procedure were acute rejection (PP 20% [7.4%, 36.8%]; I2 = 72.48%), renal dysfunction (PP 31.3% [10.5%, 57.2%]; I2 = 75.42%), multi-organ failure (PP 18.6% [2.8 to 43.9%]; I2= 69.60%), and sepsis (PP 21.1% [9%, 36.8%]; I2 = 61.19%). Conclusion Cardiac transplantation in patients with a failing Fontan is associated with acceptable interventional success and improved survival rates. Fontan (dpeaa)DE-He213 Adult congenital heart disease (dpeaa)DE-He213 Congenital heart surgery (dpeaa)DE-He213 Kotak, Sohny verfasserin aut Khatri, Mahima verfasserin aut Ahmed, Areeba verfasserin aut Ahmed, Jawad verfasserin aut Ali, Syed Saad verfasserin aut Khan, Taj M. verfasserin aut Enthalten in The cardiothoracic surgeon [Berlin, Heidelberg] : Springer, 2019 29(2021), 1 vom: 25. Feb. (DE-627)1688112510 (DE-600)3006146-5 2662-2203 nnns volume:29 year:2021 number:1 day:25 month:02 https://dx.doi.org/10.1186/s43057-021-00043-6 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 29 2021 1 25 02 |
| allfields_unstemmed |
10.1186/s43057-021-00043-6 doi (DE-627)SPR043332218 (DE-599)SPRs43057-021-00043-6-e (SPR)s43057-021-00043-6-e DE-627 ger DE-627 rakwb eng Hassan, Wardah verfasserin aut Efficacy of heart transplantation in patients with a failing Fontan: a systematic review and meta-analysis 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background As the population of patients with Fontan palliation grows, so does the number of patients with Fontan failure, necessitating heart transplantation. However, due to mainly small-sized studies, outcomes after heart transplantation in these patients remain unclear. The objective of this study was to review the available literature and conduct a meta-analysis to provide well-powered and generalizable estimates of outcomes after heart transplantation in patients with a failing Fontan. Main text PubMed, Embase, and MEDLINE databases were searched for original studies of patients with a failing Fontan who underwent heart transplantation. The outcomes included were 1-year and 5-year survival, acute rejection, renal dysfunction, sepsis, and multi-organ failure. Proportions were pooled using random effects models to derive pooled proportions (PPs) and corresponding 95% confidence intervals (CIs). Meta-regression analysis was done to study the effects of age and gender on key outcomes. Sixteen retrospective single-center cohort studies with 426 Fontan patients undergoing heart transplantation were included in this meta-analysis. Pooled analysis of this study further revealed that 1-year survival after heart transplantation was 79.9% ([75.8%, 83.7%]; I2 = 1.92%), and 5-year survival rate was 72.5% ([62.1%, 81.9%]; I2 = 72.12%). Secondary outcomes after heart transplantation of failed Fontan procedure were acute rejection (PP 20% [7.4%, 36.8%]; I2 = 72.48%), renal dysfunction (PP 31.3% [10.5%, 57.2%]; I2 = 75.42%), multi-organ failure (PP 18.6% [2.8 to 43.9%]; I2= 69.60%), and sepsis (PP 21.1% [9%, 36.8%]; I2 = 61.19%). Conclusion Cardiac transplantation in patients with a failing Fontan is associated with acceptable interventional success and improved survival rates. Fontan (dpeaa)DE-He213 Adult congenital heart disease (dpeaa)DE-He213 Congenital heart surgery (dpeaa)DE-He213 Kotak, Sohny verfasserin aut Khatri, Mahima verfasserin aut Ahmed, Areeba verfasserin aut Ahmed, Jawad verfasserin aut Ali, Syed Saad verfasserin aut Khan, Taj M. verfasserin aut Enthalten in The cardiothoracic surgeon [Berlin, Heidelberg] : Springer, 2019 29(2021), 1 vom: 25. Feb. (DE-627)1688112510 (DE-600)3006146-5 2662-2203 nnns volume:29 year:2021 number:1 day:25 month:02 https://dx.doi.org/10.1186/s43057-021-00043-6 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 29 2021 1 25 02 |
| allfieldsGer |
10.1186/s43057-021-00043-6 doi (DE-627)SPR043332218 (DE-599)SPRs43057-021-00043-6-e (SPR)s43057-021-00043-6-e DE-627 ger DE-627 rakwb eng Hassan, Wardah verfasserin aut Efficacy of heart transplantation in patients with a failing Fontan: a systematic review and meta-analysis 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background As the population of patients with Fontan palliation grows, so does the number of patients with Fontan failure, necessitating heart transplantation. However, due to mainly small-sized studies, outcomes after heart transplantation in these patients remain unclear. The objective of this study was to review the available literature and conduct a meta-analysis to provide well-powered and generalizable estimates of outcomes after heart transplantation in patients with a failing Fontan. Main text PubMed, Embase, and MEDLINE databases were searched for original studies of patients with a failing Fontan who underwent heart transplantation. The outcomes included were 1-year and 5-year survival, acute rejection, renal dysfunction, sepsis, and multi-organ failure. Proportions were pooled using random effects models to derive pooled proportions (PPs) and corresponding 95% confidence intervals (CIs). Meta-regression analysis was done to study the effects of age and gender on key outcomes. Sixteen retrospective single-center cohort studies with 426 Fontan patients undergoing heart transplantation were included in this meta-analysis. Pooled analysis of this study further revealed that 1-year survival after heart transplantation was 79.9% ([75.8%, 83.7%]; I2 = 1.92%), and 5-year survival rate was 72.5% ([62.1%, 81.9%]; I2 = 72.12%). Secondary outcomes after heart transplantation of failed Fontan procedure were acute rejection (PP 20% [7.4%, 36.8%]; I2 = 72.48%), renal dysfunction (PP 31.3% [10.5%, 57.2%]; I2 = 75.42%), multi-organ failure (PP 18.6% [2.8 to 43.9%]; I2= 69.60%), and sepsis (PP 21.1% [9%, 36.8%]; I2 = 61.19%). Conclusion Cardiac transplantation in patients with a failing Fontan is associated with acceptable interventional success and improved survival rates. Fontan (dpeaa)DE-He213 Adult congenital heart disease (dpeaa)DE-He213 Congenital heart surgery (dpeaa)DE-He213 Kotak, Sohny verfasserin aut Khatri, Mahima verfasserin aut Ahmed, Areeba verfasserin aut Ahmed, Jawad verfasserin aut Ali, Syed Saad verfasserin aut Khan, Taj M. verfasserin aut Enthalten in The cardiothoracic surgeon [Berlin, Heidelberg] : Springer, 2019 29(2021), 1 vom: 25. Feb. (DE-627)1688112510 (DE-600)3006146-5 2662-2203 nnns volume:29 year:2021 number:1 day:25 month:02 https://dx.doi.org/10.1186/s43057-021-00043-6 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 29 2021 1 25 02 |
| allfieldsSound |
10.1186/s43057-021-00043-6 doi (DE-627)SPR043332218 (DE-599)SPRs43057-021-00043-6-e (SPR)s43057-021-00043-6-e DE-627 ger DE-627 rakwb eng Hassan, Wardah verfasserin aut Efficacy of heart transplantation in patients with a failing Fontan: a systematic review and meta-analysis 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background As the population of patients with Fontan palliation grows, so does the number of patients with Fontan failure, necessitating heart transplantation. However, due to mainly small-sized studies, outcomes after heart transplantation in these patients remain unclear. The objective of this study was to review the available literature and conduct a meta-analysis to provide well-powered and generalizable estimates of outcomes after heart transplantation in patients with a failing Fontan. Main text PubMed, Embase, and MEDLINE databases were searched for original studies of patients with a failing Fontan who underwent heart transplantation. The outcomes included were 1-year and 5-year survival, acute rejection, renal dysfunction, sepsis, and multi-organ failure. Proportions were pooled using random effects models to derive pooled proportions (PPs) and corresponding 95% confidence intervals (CIs). Meta-regression analysis was done to study the effects of age and gender on key outcomes. Sixteen retrospective single-center cohort studies with 426 Fontan patients undergoing heart transplantation were included in this meta-analysis. Pooled analysis of this study further revealed that 1-year survival after heart transplantation was 79.9% ([75.8%, 83.7%]; I2 = 1.92%), and 5-year survival rate was 72.5% ([62.1%, 81.9%]; I2 = 72.12%). Secondary outcomes after heart transplantation of failed Fontan procedure were acute rejection (PP 20% [7.4%, 36.8%]; I2 = 72.48%), renal dysfunction (PP 31.3% [10.5%, 57.2%]; I2 = 75.42%), multi-organ failure (PP 18.6% [2.8 to 43.9%]; I2= 69.60%), and sepsis (PP 21.1% [9%, 36.8%]; I2 = 61.19%). Conclusion Cardiac transplantation in patients with a failing Fontan is associated with acceptable interventional success and improved survival rates. Fontan (dpeaa)DE-He213 Adult congenital heart disease (dpeaa)DE-He213 Congenital heart surgery (dpeaa)DE-He213 Kotak, Sohny verfasserin aut Khatri, Mahima verfasserin aut Ahmed, Areeba verfasserin aut Ahmed, Jawad verfasserin aut Ali, Syed Saad verfasserin aut Khan, Taj M. verfasserin aut Enthalten in The cardiothoracic surgeon [Berlin, Heidelberg] : Springer, 2019 29(2021), 1 vom: 25. Feb. (DE-627)1688112510 (DE-600)3006146-5 2662-2203 nnns volume:29 year:2021 number:1 day:25 month:02 https://dx.doi.org/10.1186/s43057-021-00043-6 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 29 2021 1 25 02 |
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Enthalten in The cardiothoracic surgeon 29(2021), 1 vom: 25. Feb. volume:29 year:2021 number:1 day:25 month:02 |
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Hassan, Wardah @@aut@@ Kotak, Sohny @@aut@@ Khatri, Mahima @@aut@@ Ahmed, Areeba @@aut@@ Ahmed, Jawad @@aut@@ Ali, Syed Saad @@aut@@ Khan, Taj M. @@aut@@ |
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However, due to mainly small-sized studies, outcomes after heart transplantation in these patients remain unclear. The objective of this study was to review the available literature and conduct a meta-analysis to provide well-powered and generalizable estimates of outcomes after heart transplantation in patients with a failing Fontan. Main text PubMed, Embase, and MEDLINE databases were searched for original studies of patients with a failing Fontan who underwent heart transplantation. The outcomes included were 1-year and 5-year survival, acute rejection, renal dysfunction, sepsis, and multi-organ failure. Proportions were pooled using random effects models to derive pooled proportions (PPs) and corresponding 95% confidence intervals (CIs). Meta-regression analysis was done to study the effects of age and gender on key outcomes. Sixteen retrospective single-center cohort studies with 426 Fontan patients undergoing heart transplantation were included in this meta-analysis. Pooled analysis of this study further revealed that 1-year survival after heart transplantation was 79.9% ([75.8%, 83.7%]; I2 = 1.92%), and 5-year survival rate was 72.5% ([62.1%, 81.9%]; I2 = 72.12%). Secondary outcomes after heart transplantation of failed Fontan procedure were acute rejection (PP 20% [7.4%, 36.8%]; I2 = 72.48%), renal dysfunction (PP 31.3% [10.5%, 57.2%]; I2 = 75.42%), multi-organ failure (PP 18.6% [2.8 to 43.9%]; I2= 69.60%), and sepsis (PP 21.1% [9%, 36.8%]; I2 = 61.19%). Conclusion Cardiac transplantation in patients with a failing Fontan is associated with acceptable interventional success and improved survival rates.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Fontan</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Adult congenital heart disease</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Congenital heart surgery</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Kotak, Sohny</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Khatri, Mahima</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Ahmed, Areeba</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Ahmed, Jawad</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Ali, Syed Saad</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Khan, Taj M.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">Enthalten in</subfield><subfield code="t">The cardiothoracic surgeon</subfield><subfield code="d">[Berlin, Heidelberg] : Springer, 2019</subfield><subfield code="g">29(2021), 1 vom: 25. 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Efficacy of heart transplantation in patients with a failing Fontan: a systematic review and meta-analysis Fontan (dpeaa)DE-He213 Adult congenital heart disease (dpeaa)DE-He213 Congenital heart surgery (dpeaa)DE-He213 |
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efficacy of heart transplantation in patients with a failing fontan: a systematic review and meta-analysis |
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Efficacy of heart transplantation in patients with a failing Fontan: a systematic review and meta-analysis |
| abstract |
Background As the population of patients with Fontan palliation grows, so does the number of patients with Fontan failure, necessitating heart transplantation. However, due to mainly small-sized studies, outcomes after heart transplantation in these patients remain unclear. The objective of this study was to review the available literature and conduct a meta-analysis to provide well-powered and generalizable estimates of outcomes after heart transplantation in patients with a failing Fontan. Main text PubMed, Embase, and MEDLINE databases were searched for original studies of patients with a failing Fontan who underwent heart transplantation. The outcomes included were 1-year and 5-year survival, acute rejection, renal dysfunction, sepsis, and multi-organ failure. Proportions were pooled using random effects models to derive pooled proportions (PPs) and corresponding 95% confidence intervals (CIs). Meta-regression analysis was done to study the effects of age and gender on key outcomes. Sixteen retrospective single-center cohort studies with 426 Fontan patients undergoing heart transplantation were included in this meta-analysis. Pooled analysis of this study further revealed that 1-year survival after heart transplantation was 79.9% ([75.8%, 83.7%]; I2 = 1.92%), and 5-year survival rate was 72.5% ([62.1%, 81.9%]; I2 = 72.12%). Secondary outcomes after heart transplantation of failed Fontan procedure were acute rejection (PP 20% [7.4%, 36.8%]; I2 = 72.48%), renal dysfunction (PP 31.3% [10.5%, 57.2%]; I2 = 75.42%), multi-organ failure (PP 18.6% [2.8 to 43.9%]; I2= 69.60%), and sepsis (PP 21.1% [9%, 36.8%]; I2 = 61.19%). Conclusion Cardiac transplantation in patients with a failing Fontan is associated with acceptable interventional success and improved survival rates. |
| abstractGer |
Background As the population of patients with Fontan palliation grows, so does the number of patients with Fontan failure, necessitating heart transplantation. However, due to mainly small-sized studies, outcomes after heart transplantation in these patients remain unclear. The objective of this study was to review the available literature and conduct a meta-analysis to provide well-powered and generalizable estimates of outcomes after heart transplantation in patients with a failing Fontan. Main text PubMed, Embase, and MEDLINE databases were searched for original studies of patients with a failing Fontan who underwent heart transplantation. The outcomes included were 1-year and 5-year survival, acute rejection, renal dysfunction, sepsis, and multi-organ failure. Proportions were pooled using random effects models to derive pooled proportions (PPs) and corresponding 95% confidence intervals (CIs). Meta-regression analysis was done to study the effects of age and gender on key outcomes. Sixteen retrospective single-center cohort studies with 426 Fontan patients undergoing heart transplantation were included in this meta-analysis. Pooled analysis of this study further revealed that 1-year survival after heart transplantation was 79.9% ([75.8%, 83.7%]; I2 = 1.92%), and 5-year survival rate was 72.5% ([62.1%, 81.9%]; I2 = 72.12%). Secondary outcomes after heart transplantation of failed Fontan procedure were acute rejection (PP 20% [7.4%, 36.8%]; I2 = 72.48%), renal dysfunction (PP 31.3% [10.5%, 57.2%]; I2 = 75.42%), multi-organ failure (PP 18.6% [2.8 to 43.9%]; I2= 69.60%), and sepsis (PP 21.1% [9%, 36.8%]; I2 = 61.19%). Conclusion Cardiac transplantation in patients with a failing Fontan is associated with acceptable interventional success and improved survival rates. |
| abstract_unstemmed |
Background As the population of patients with Fontan palliation grows, so does the number of patients with Fontan failure, necessitating heart transplantation. However, due to mainly small-sized studies, outcomes after heart transplantation in these patients remain unclear. The objective of this study was to review the available literature and conduct a meta-analysis to provide well-powered and generalizable estimates of outcomes after heart transplantation in patients with a failing Fontan. Main text PubMed, Embase, and MEDLINE databases were searched for original studies of patients with a failing Fontan who underwent heart transplantation. The outcomes included were 1-year and 5-year survival, acute rejection, renal dysfunction, sepsis, and multi-organ failure. Proportions were pooled using random effects models to derive pooled proportions (PPs) and corresponding 95% confidence intervals (CIs). Meta-regression analysis was done to study the effects of age and gender on key outcomes. Sixteen retrospective single-center cohort studies with 426 Fontan patients undergoing heart transplantation were included in this meta-analysis. Pooled analysis of this study further revealed that 1-year survival after heart transplantation was 79.9% ([75.8%, 83.7%]; I2 = 1.92%), and 5-year survival rate was 72.5% ([62.1%, 81.9%]; I2 = 72.12%). Secondary outcomes after heart transplantation of failed Fontan procedure were acute rejection (PP 20% [7.4%, 36.8%]; I2 = 72.48%), renal dysfunction (PP 31.3% [10.5%, 57.2%]; I2 = 75.42%), multi-organ failure (PP 18.6% [2.8 to 43.9%]; I2= 69.60%), and sepsis (PP 21.1% [9%, 36.8%]; I2 = 61.19%). Conclusion Cardiac transplantation in patients with a failing Fontan is associated with acceptable interventional success and improved survival rates. |
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However, due to mainly small-sized studies, outcomes after heart transplantation in these patients remain unclear. The objective of this study was to review the available literature and conduct a meta-analysis to provide well-powered and generalizable estimates of outcomes after heart transplantation in patients with a failing Fontan. Main text PubMed, Embase, and MEDLINE databases were searched for original studies of patients with a failing Fontan who underwent heart transplantation. The outcomes included were 1-year and 5-year survival, acute rejection, renal dysfunction, sepsis, and multi-organ failure. Proportions were pooled using random effects models to derive pooled proportions (PPs) and corresponding 95% confidence intervals (CIs). Meta-regression analysis was done to study the effects of age and gender on key outcomes. Sixteen retrospective single-center cohort studies with 426 Fontan patients undergoing heart transplantation were included in this meta-analysis. Pooled analysis of this study further revealed that 1-year survival after heart transplantation was 79.9% ([75.8%, 83.7%]; I2 = 1.92%), and 5-year survival rate was 72.5% ([62.1%, 81.9%]; I2 = 72.12%). Secondary outcomes after heart transplantation of failed Fontan procedure were acute rejection (PP 20% [7.4%, 36.8%]; I2 = 72.48%), renal dysfunction (PP 31.3% [10.5%, 57.2%]; I2 = 75.42%), multi-organ failure (PP 18.6% [2.8 to 43.9%]; I2= 69.60%), and sepsis (PP 21.1% [9%, 36.8%]; I2 = 61.19%). 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